California’s Johnson & Johnson Vaccine Supply Plummets Just As Millions More Residents Become Eligible

“I encourage everybody to avail themselves [of the vaccine] next week, everybody over 16,” said California Governor Gavin Newsom on Thursday. State residents may find it hard to follow through on the governor’s advice, however, because California is set to see a 15% drop in overall vaccine supply and an 88% drop in Johnson & Johnson shots just as millions more residents become eligible for vaccination.

When Newsom announced the expansion of vaccine eligibility to all residents over the age of 16 on April 15, there were concerns about vaccine supply. The governor himself has said the state’s vaccination program is only constrained by manufactured supply.

At the time of that announcement, a statement from the governor’s office said, “California expects to be allocated approximately 2.5 million first and second doses per week in the first half of April, and more than 3 million doses in the second half of April.”

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Late Wednesday, the governor’s office revealed that the projected allocations had dropped precipitously. This week, the allocation was 2.4 million doses. Next week, however, it will drop to 2 million doses, a 15% decline. The week after, just 1.9 million doses, down another 5%. That’s over a million doses short of the previously expected “3 million doses in the second half of April.”

Supply will be even tighter for those seeking first doses. While this week there are 1.49 million first shots available, that supply will fall by 1/3 next week to 1 million and another 4% the following week to just 956,000 first doses.

The declines are mostly due to a drop in J&J vaccine supply after a manufacturing error at a Baltimore facility contaminated 15 million doses.

Asked about the error on April 1 Newsom was optimistic saying, “Here’s what we’ve been told: That our three week window on J&J has not been impacted by this manufacturing issue in Baltimore, which means — let me be specific — that we anticipate receiving 572,700 doses next [now this] week of J&J, 215,400 doses a week later and 215,400 doses the week after that.”

California health officials announced late Wednesday, however, that while this week’s allocation of J&J was a robust 574,900 doses, next week’s would be just 67,600 and then week after 22,400. The timing is not good.

While only the Pfizer vaccine is approved for those 16 and 17 years of age, the drop in Johnson & Johnson doses puts a pinch on the whole system, forcing health officials to prioritize second doses to make sure the mass of those recently given their first shots will be able to complete their vaccinations, even as supply drops.

California health officials point out that these three week projections only account for about 70% of the state’s supply. There is another 30% sent by the federal government directly to pharmacies, some mass vaccination sites and other entities. Some of those doses may come from supply pools unaffected by the manufacturing mishap in Baltimore. Newsom himself got such a dose, announcing moments after being vaccinated on April 1, “The J&J dose that I just received comes from The Netherlands. It’s independent of that [state] supply.”

The governor also said at the time that the state was expecting an increase in Pfizer and Moderna supplies. That does not seem to have materialized, however, since total projections in the coming weeks are down more than just the number of missing J&J doses.

California officials note that states across the country are seeing precipitous drops of J&J vaccine in the coming weeks. That is absolutely true. The difference is that not all those states have planned an aggressive expansion of vaccination eligibility at exactly the same moment.

The last time the governor announced a major expansion of vaccine eligibility was on March 15, when he directed that Covid-19 vaccine appointments be made available to people aged 16-65 years old with an underlying health condition. That group comprised 4.4 million Californians.

The timing of that expansion was also problematic. It coincided directly with what Marta Green — a state official tapped to oversee the third-party vaccine administrator — called a “really challenging” moment.

“When we look at the concrete information we have,” said Green, “that 3-week projection from the CDC, I hate to tell you this, it is entirely flat. There is not a single [additional] dose. Not one.”

So the governor vastly expanded the pool of vaccine-eligible Californians at the very moment the state would have no additional supply. County health officials across the state expressed concerns — not for the first time.

On his second day in office, President Biden promised local health officials a three-week window on incoming vaccine supplies. Newsom had, as of March 31, still not provided L.A. officials with projections more than one week out.

Why are three-week projections important? Vaccination sites need to be able to have people scheduled for a number of appointments that match the number of doses coming in. Ideally, that’s a process that happens weeks ahead of time. When it doesn’t, you get examples like Dodger Stadium, which can deliver upwards of 7,000 vaccinations a day, but shut down last month because vaccine deliveries didn’t match appointments. Thus the nation’s largest vaccination site had to close its gates for two days.

“This week we only received 16,000 new doses,” said Mayor Garcetti at the time. “That’s about the number of new doses we give out every single day,” he said. “That is down 90,000 from the week before. That is unacceptable.”

President Biden has also promised there will be enough vaccine to open eligibility for everyone by April 19. However, local health officials in CA have repeatedly encountered bottlenecks at the state level. Those issues have centered around promises made and promises kept — and around the lack of information on vaccine supplies from Sacramento.

Asked in late February about the lack of transparency the governor said, “Next week the counties will start getting their three-week window, specifically March 1st.” But March 1st came and went and Newsom’s promise was unfulfilled. He then said March 15. That date came and went, as well, with no movement.

Last week, Los Angeles public health officials said, for the first time, that they had three-week projections. That achievement was short-lived, however. Asked about the lack of predictable appointments this week, L.A. County Public Health Director Barbara Ferrer said on Wednesday, “We’re still struggling to release appointments ahead of time. We’ll really trying to get a smoother forecast.”

That there is still choppiness and uncertainty in California’s largest metropolis as the state attempts its largest eligibility expansion to date next week is problematic. And those newly vaccine eligible Californians 16-49 years old may be the group that needs the vaccine most right now.

Numbers shared by Los Angeles County Public Health officials on Wednesday indicate that Covid-related hospitalizations have risen in the past two weeks with every age cohort between the ages of 12 and 49. (Reminder here that those 50+ became eligible last week while those 65+ have been getting vaccinated since mid-January.) See chart below.

Cases among young adults are also rising across the nation, according to Dr. Rochelle Walensky, the head of the federal Centers for Disease Control and Prevention. “The trends and data have been indicating cases are increasing nationally as we are seeing this occur predominantly in younger adults,” she said on Monday.

Those conclusions were amplified a day later by Dr. Anthony Fauci. “We’re seeing more and more young people get into serious trouble,” he said, “namely severe disease, requiring hospitalization and occasionally even tragic deaths in quite young people.”

That may have something to do with the rise of more infectious variants across the country, and the increased susceptibility of young Americans to those variants vs. the country’s older, more-vaccinated population. It’s a trend from which California is not immune.

The state and some of its largest communities have begun to see some Covid numbers rise again. That’s happening as the majority of Covid-19 test samples genomically analyzed in Los Angeles County last week turned out to be variants of concern, meaning the variants are now more common than the “wild” version of the virus. That list was led by the more infectious U.K. variant — known as B.1.1.7 — which this week also became the dominant strain in the U.S. The CDC says the U.K. variant is 50% more transmissible than the wild variant.

Of course, just this week the embattled Newsom announced that the state plans to drop most of its Covid-19 restrictions on June 15 so long as infection and vaccination numbers continue to move in the right direction.

The rising numbers, if they continue, could test Governor Newsom’s assertion this week — and for the past year — that any reopenings will be “driven by data.”

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